Our little campfire just outside our home last night. It's nice with cool weather, plenty of wood from living in the woods, and plenty of supplies to make s'mores.
I've decided to give folks an update once again. I apologize for not being more diligent in my blog, but I suppose I've had to be more diligent about other things as of late. I just finished my second week of the surgery rotation, so where to begin with the story telling? I started out on plastic surgery, and have been there for the last two weeks. Let me first dispel some possible misconceptions about what a plastic surgeon does. Plastics is derived from the Greek word "plastikos," meaning to mold or shape. In the mind of a surgeon, this of course translates to the molding and shaping of human tissues. Sure they are great at making incisions and then stitching them up beautifully, but it's not all about boob and nose jobs. Perhaps in a more private practice setting, this would be the bulk of the clientele. But in working with a plastic surgeon who works for the hospitals, things are a little different. Most of our adult patients were older men, with a woman here and there, who were in a bed or wheelchair chronically for whatever reason, and had subsequently developed stage IV bed sores, or ulcers. Stage IV is bad, very bad, sores that go all the way down to the bone bad. Surgeries often entailed cutting a bunch of unhealthy tissue out, which often included shaving or pounding away at questionable bone, usually the pelvic bones. The wound gets left open for several days and then we go back and close the gaping holes left behind and pray the patient doesn't do something to dehisce (split open) the wound.
The surgeon with whom I worked managed patients at UAMS, the VA, and ACH, which meant a lot of traveling for me. At the children's hospital, we saw kids with one too many fingers, malformed ear lobes, and various other malformities. He also did a fellowship in hand surgery, so he sees orthopaedic hand cases - broken hands and the sort. I have been at Children's far more than any other place. It's been an overall excellent experience, sans clinic days when all I did was follow him around without any autonomy for myself. He said I was a big help in surgeries, at one point complemented me on my eye-hand coordination (thank you Half-Life and TR), and claimed he would give me a good grade. Next, I start vascular surgery at the VA tomorrow.
Now for a word on ATV's. Part of the problem may be that I grew up in the suburbs and didn't really have any friends or family with land where an ATV was a reasonable thing to own. But at the end of the day, regardless of my past, I have decided ATV's are a horrible idea, especially for kids under 16 or so, and ESPECIALLY for riders without a helmet. Let me explain myself. Right from the start of surgery, I met a young girl who suffered a terrible ATV accident. She was crossing the road when a truck collided with her. Had it not been for an EMS individual smart enough to put a tourniquet on her destroyed leg, she would have died right there on the side of the road from hypovolemic shock (blood loss). When she came to the OR (at least the second time around by the first time I saw her), she had no skin on the front and sides of her leg from just above her knee all the way down to her foot. There at the foot she had intact (although burned) skin continuous with skin that ran up her calf. Her bones already had rods placed in them and were broken so badly they didn't touch. The muscles in the front of her leg, the ones that allow you to pull your foot and toes up, were all gone - exposing much of the bone to all of God's creation if not in a cast. After two or three two-hour surgeries to clean the massive wound and cut away dead tissue, another eight to nine hour surgery underwent to place a muscle flap harvested from her back to cover her exposed leg bones and destroyed muscles. This was done so a skin graft could be started a few days later with synthetic skin since skin wont grow over exposed bone. Eventually, she will have real skin grafts placed over the artificial skin one piece at a time. I met a few other girls on clinic days who were further along their course of hours of work. Just this morning, with my eye enucleation job, there was a kid who died flipping head over handlebars from his ATV - no helmet = one very dead kid about to donate the one of his eyes that was salvageable. I unfortunately was unable to attend the case, but I heard all about it from the coworker who did. If you ride an ATV, fine, just don't be a retard. Don't put your kids on it (or a riding lawnmower for that matter), and for God's sake, wear a helmet.
I don't recall if I have given you a formal decision yet, but I have decided to train for the full marathon this year. If it doesn't quite work out, then I should have no problem being trained enough to do the half marathon. I ran nine miles today, and for the first time since I started training, I truly feel pooped out. Lord, beer me strength.
See you soon!
I've decided to give folks an update once again. I apologize for not being more diligent in my blog, but I suppose I've had to be more diligent about other things as of late. I just finished my second week of the surgery rotation, so where to begin with the story telling? I started out on plastic surgery, and have been there for the last two weeks. Let me first dispel some possible misconceptions about what a plastic surgeon does. Plastics is derived from the Greek word "plastikos," meaning to mold or shape. In the mind of a surgeon, this of course translates to the molding and shaping of human tissues. Sure they are great at making incisions and then stitching them up beautifully, but it's not all about boob and nose jobs. Perhaps in a more private practice setting, this would be the bulk of the clientele. But in working with a plastic surgeon who works for the hospitals, things are a little different. Most of our adult patients were older men, with a woman here and there, who were in a bed or wheelchair chronically for whatever reason, and had subsequently developed stage IV bed sores, or ulcers. Stage IV is bad, very bad, sores that go all the way down to the bone bad. Surgeries often entailed cutting a bunch of unhealthy tissue out, which often included shaving or pounding away at questionable bone, usually the pelvic bones. The wound gets left open for several days and then we go back and close the gaping holes left behind and pray the patient doesn't do something to dehisce (split open) the wound.
The surgeon with whom I worked managed patients at UAMS, the VA, and ACH, which meant a lot of traveling for me. At the children's hospital, we saw kids with one too many fingers, malformed ear lobes, and various other malformities. He also did a fellowship in hand surgery, so he sees orthopaedic hand cases - broken hands and the sort. I have been at Children's far more than any other place. It's been an overall excellent experience, sans clinic days when all I did was follow him around without any autonomy for myself. He said I was a big help in surgeries, at one point complemented me on my eye-hand coordination (thank you Half-Life and TR), and claimed he would give me a good grade. Next, I start vascular surgery at the VA tomorrow.
Now for a word on ATV's. Part of the problem may be that I grew up in the suburbs and didn't really have any friends or family with land where an ATV was a reasonable thing to own. But at the end of the day, regardless of my past, I have decided ATV's are a horrible idea, especially for kids under 16 or so, and ESPECIALLY for riders without a helmet. Let me explain myself. Right from the start of surgery, I met a young girl who suffered a terrible ATV accident. She was crossing the road when a truck collided with her. Had it not been for an EMS individual smart enough to put a tourniquet on her destroyed leg, she would have died right there on the side of the road from hypovolemic shock (blood loss). When she came to the OR (at least the second time around by the first time I saw her), she had no skin on the front and sides of her leg from just above her knee all the way down to her foot. There at the foot she had intact (although burned) skin continuous with skin that ran up her calf. Her bones already had rods placed in them and were broken so badly they didn't touch. The muscles in the front of her leg, the ones that allow you to pull your foot and toes up, were all gone - exposing much of the bone to all of God's creation if not in a cast. After two or three two-hour surgeries to clean the massive wound and cut away dead tissue, another eight to nine hour surgery underwent to place a muscle flap harvested from her back to cover her exposed leg bones and destroyed muscles. This was done so a skin graft could be started a few days later with synthetic skin since skin wont grow over exposed bone. Eventually, she will have real skin grafts placed over the artificial skin one piece at a time. I met a few other girls on clinic days who were further along their course of hours of work. Just this morning, with my eye enucleation job, there was a kid who died flipping head over handlebars from his ATV - no helmet = one very dead kid about to donate the one of his eyes that was salvageable. I unfortunately was unable to attend the case, but I heard all about it from the coworker who did. If you ride an ATV, fine, just don't be a retard. Don't put your kids on it (or a riding lawnmower for that matter), and for God's sake, wear a helmet.
I don't recall if I have given you a formal decision yet, but I have decided to train for the full marathon this year. If it doesn't quite work out, then I should have no problem being trained enough to do the half marathon. I ran nine miles today, and for the first time since I started training, I truly feel pooped out. Lord, beer me strength.
See you soon!
